Replacing a very seriously ill organ with a healthy one, taken from a man who died accidentally, is a radical solution, possibly life-saving to the recipient, in the face of the inability of modern medicine to cure the disease by other means.
Lung transplantation has become
an accepted procedure for advanced lung disease, and more than 25,000
transplants have been performed worldwide since 1990. Doctor Muhammad Khan
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physicians in the USA. The
transplant usually replaces both lungs, keeping the heart and large vessels
intact.
Indications for lung
transplantation
Lung transplantation is indicated
in patients suffering from one of the diseases in which there is no effective
treatment and which evolves relatively rapidly towards the total inability of
the lungs to fulfil its essential function of bringing oxygen, leading to
premature death.
Diseases for which lung transplantation is
recommended include:
·
Very severe COPD
·
Idiopathic pulmonary fibrosis
·
Cystic fibrosis (cystic fibrosis)
·
Alpha-1-antitrypsin genetic deficiency
·
Primitive pulmonary hypertension
·
Other rarer diseases
Among the diseases with severe
damage, but transplantation is not recommended are collagenases with lung
damage and sarcoidosis. These being considered diseases with systemic damage
(of several organs), there is a risk that the new lungs will also be affected
by the disease. Transplantation is also contraindicated in smokers, those with
a history of cancer in the last 2 years, poor nutritional status (cachexia),
and those with complex or non-compliant psychosocial problems. Patients over
the age of 65 are not accepted for transplantation. Get the best Colon cancer treatment in the USA.
When is a lung transplant indicated?
When life expectancy does not
exceed 24-36 months, despite the existing optimal treatment, and when patients
have symptoms corresponding to classes III and IV NYHA (New York Heart
Association).
Specific criteria for idiopathic
pulmonary fibrosis:
·
Vital capacity below 60-65% of the predicted
value
·
A decrease of more than 10% in vital capacity in
6 months
·
Reduction of alveolo-capillary diffusion: DLCO
<39% of the predicted value
·
Decreased oxygen saturation below 88% on the
6-minute walk test.
Preoperative evaluation
To assess whether a patient is
suitable for lung transplantation, a multitude of tests are initially performed
to assess the condition of the lungs, the general condition of the patient, the
condition of the heart, to identify possible chronic infections that could
endanger the new organ (hepatitis virus tests, HIV, tuberculosis infection), to
identify the existence of other serious diseases of other organs, which may
interfere with the evolution of the patient.
Thus, in addition to specific
tests for the disease for which the transplant is performed, many other
investigations are performed: cardiac ultrasound, coronary angiography, cardiac
catheterization to measure pulmonary artery pressure, peripheral artery Doppler
ultrasound, abdominal ultrasound, lung scintigraphy, PET-CT for exclusion a
possible unidentified cancer, gynaecological examination or prostate. It is
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Complex genetic and immunological
investigations are needed to define the patient's compatibility with a
potential donor. The simplest example is the blood type.
Where can a lung transplant be done?
Unfortunately, lung
transplantation is not currently performed in Romania. Therefore, transplant
patients are referred to other specialist clinics in Europe, such as Vienna,
Paris, or other western countries. The admission of a patient to such a clinic
depends on the policy of that country, in so far as the few available organs
can be transferred to a candidate from another country. Currently, most lung
transplants have been performed in Vienna, with 10 lung transplant patients in
the Romanian Ministry of Health database. Based on a solid medical record and
the acceptance in principle of the clinic abroad, the Ministry of Health pays
the clinic the amount necessary for the transplant and subsequent checks.
Waiting list
After complex evaluation and
acceptance of the transplant patient, he is placed on a waiting list. It is
based on several priority criteria specific to the transplant clinic, among
which the age of the patient and the severity of the disease are important
criteria. However, given the limited availability of donors and the
"luck" of finding a compatible donor, the wait can be extended to
over a year, maybe even two. The patient may die while waiting for the
transplant, as there was at least one case when the patient was called 3 days
after being placed on the active list.
When a compatible donor is found,
the patient is called and must show up at the airport within 3 hours. The
transport to the transplant clinic is done with a special medical plane
dedicated to this purpose.
Life after transplantation
Patients who have received a
transplanted organ should undergo immunosuppressive treatment for the rest of
their lives to prevent the body's immune system from rejecting the new organ,
which is considered foreign or non-self. The rejection reaction is the lower
the compatibility between the recipient and the donated organ.
Immunosuppressive therapy puts
the patient at increased risk of bacterial, viral, or fungal infections, so
patients should avoid exposure to infections as much as possible. Patients should
have regular check-ups to identify any early rejection reaction, which may be
the appearance of an acute illness or chronic changes. For lung
transplantation, bronchoscopy with Transbronchial biopsy is performed during
the examinations, with a microscopic examination of a sample of lung tissue and
early identification of specific inflammatory changes. Doctor Muhammad Khan
provides the best Clinical
Consultation in
the USA. The rejection reaction is a serious threat to the integrity of
the transplanted lungs. It can cause transplant failure, creating another lung
disease that can be as serious as the initial one. Survival after lung
transplantation is not as good as in other organs. Thus, the 5-year survival
after transplantation is about 54% for the lungs, compared to 73% for the liver
or 91% for the kidneys from the living donor.
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